title: [Differences in the nursing consultation utilization in primary care, Spain].
abstract: BACKGROUND
  Different conditions in health services utilization may create situations of inequity. The objective was analyze the differences of nurse consultation utilization in primary care.
  
  
  METHODS
  Cross-sectional study, in 23 health centres in Madrid. Environmental variables, consultation characteristics, socio-demographic and health need characteristics were collected. The quality of life and satisfaction were also studied. The variables were classified according to the "behavioral model" in predisposing, enabling or need variables. Explanatory multivariate models were constructed (Generalized-Estimating-Equations).
  
  
  RESULTS
  The higher income areas and aging, predisposing factors, were associated with increases of 17% (95% CI: 0.4 to 36.9%) and 11.0% per decade (95% CI: 6.2 - 16.2) in nursing consultations per year. Among enabling factors, each additional minute of consultation length was associated with an increase of 2.0% (95% CI :1.2-2, 9%) in number of nurse consultations, each new medical consultation was associated with a increase of 2.7% (95% CI: 2.1-3.2%) and the delay in getting appointment over a day, represented a decrease of 32.8% (95% CI: 19.3 to 44.1%) in the total nursing consultations. Each chronic condition, which expresses the need health, was associated with an increase in the number of visits of 4.8% (95% CI: 1.7 to 8.0%). The improved perception of quality of life was associated with a reduction of 5.4% (95% CI 1.0 to 8.7%) of the consultations.
  
  
  CONCLUSIONS
  The difference of the use of primary care nurse consultations is based on health need criteria, but is also influenced by accessibility conditions.
authors.affiliation: Consultorio de Villamanta, Centro de Salud Navalcarnero, Gerencia de Atención Primaria de Madrid, Madrid, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Martín-Fernández
authors.forename: Gemma
authors.initials: G
authors.lastname: Rodríguez-Martínez
authors.forename: Gloria
authors.initials: G
authors.lastname: Ariza-Cardiel
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: Vergel Gutierrez
authors.forename: Ana Victoria
authors.initials: AV
authors.lastname: Hidalgo Escudero
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Conde-López
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D012959:Socioeconomic Factors; D013030:Spain